Waste Management 12.6 - SIHFW) Rajasthan Management.pdf · linen & linen, Gloves, Catheters, Cannulas, Blood bags, Tape, Hot water Paper Glasses Flowers Milk Fluid bottles, Disposable

Health Health Care Waste Care Waste ManagementManagement

State Institute of Health & Family Welfare, J iJaipur

ProblemLegislationgIssuesProcessTechnologyPlanningPlanning

SIHFW: an ISO 9001: 2008 certified institution 2

Source & Waste TypeSourceSource RecyclableRecyclable

BLACKReusableReusableBLACK/ / REDRED

InfectiousInfectiousSharps NonSharps Non--

sharpssharps

NonNon--infectiousinfectious

Gen.Gen.wastewaste

REDRED sharpssharpsOPDOPD Paper/ Paper/

Packaging/Packaging/CigaretteCigarette/ / BidiBidi //GutakaGutaka//PaperPaper

IPDIPD Paper, Paper, packing,packing,EmptyEmpty

GlassGlass--bottles, bottles, syringes,syringes,

NeedlesNeedles D. D. syringes,syringes,SoiledSoiled

UroUro bags bags without without blood, blood,

Left overLeft overFood,Food,PeelingPeelingEmpty Empty

vials,vials,Metal cans Metal cans & & container,container,

y g ,y g ,Empty Empty vials, vials, soiled soiled linen & linen &

Soiled Soiled linen,linen,Gloves,Gloves,Catheters,Catheters,CannulasCannulas,,

,,Blood Blood bags,bags,Tape,Tape,Hot water Hot water

PeelingPeelingPaperPaperGlassesGlassesFlowersFlowersMilkMilk

Fluid Fluid bottles,bottles,Disposable Disposable syringessyringes

mattressemattressess

,,IVIV--SV setsSV sets bottles & bottles &

ice caps,ice caps,Drugs Drugs

Milk Milk bagsbags

Continue…SIHFW: an ISO 9001: 2008 certified institution 3

What is Medical WasteWhat is Medical Waste

Any waste generated during– diagnosis, treatment , immunization of human

beings or animals orbeings or animals, or– research activities pertaining, thereto, or– in production & testing of biologicals, includingp g g , g

categories mentioned in schedule-I of the rules

(Bio Medical waste (handling & mgt ) rules(Bio-Medical waste (handling & mgt.) rules,1998),under Environment Protection Act of 1986).


Types of Health Care Waste

Human anatomical waste: human tissues, organs, body partspMicrobiology & Biotechnology WasteWaste sharps: needles, syringes, scalpels, glassDiscarded Medicines and Cytotoxic drugSoiled Waste: contaminated with blood, and body fluids as cotton dressings soiled plaster casts beddingsas cotton dressings, soiled plaster casts, beddingsSolid Waste: tubing, catheters, intravenous setsLiquid Waste: generated from labs, washing, cleaningLiquid Waste: generated from labs, washing, cleaningIncineration Ash: from any bio-medical wasteChemical Waste


Type of Waste Generated2.24 1.09 0.12

Cotton

Type of Waste Generated

39.179.9

9.85 Cotton

Food

10.24Paper

Glass

26.4Plastic

Miscellaneous

Syringes

NeedlesBased on a study at a Calcutta hospital NeedlesBased on a study at a Calcutta hospital


Potential RiskPotential Risk

Infection, Infestations, intoxication Needle stick injuriesContaminationPollution, emissions


Persons at RiskPersons at Risk

Health care workersPatients and their visitors/attendants at thePatients and their visitors/attendants at thesupport services staffW k i t di l f ilitiWorkers in waste disposal facilities


Problem

No authentic data, only sporadic studies to extrapolate

– 1-1.5 Kg/Bed/Day (Mumbai, Kolkatta)Public opinion-averse to dumpingInadvertent increase in proportion of risk- Mixing ofInadvertent increase in proportion of risk Mixing of wasteRisk perception- Yes, Action ?No std definition-No std. definitionMedical /Hazardous/ Bio-medical wasteProfessional apathyCl tt dCluttered concernsNo one uniform technology applicableStandards for technology ?Cost of treatment/Technology


EffortsEfforts1995, India’s Ministry of Environment and Forests drafted rules for

managing BMWs that proposed

– each health care facility with more than 30 beds or serving more

than 1,000 patients per month install an incinerator on its

premises; and

– smaller health care facilities set up a common incinerator facility.

Biomedical Waste (Handling and Management) Rules of 1998. Later

amended in 2003.


The LegislationThe Legislation-

Notification, under section 6, 8, & 25 ofEnvironment ProtectionAct,1986;issued0n 16/10/199760 days to respondy pEffective from July 20, 1998


The Legislation-BMW (Handling &Mgt.)rules,1998

(w .e .f-July 20, 1998, 2nd amendment 2003)

13 Rules

y

6 Schedules-3 Forms3 Forms


Biomedical Waste Rules, 1998Similar to those in international practiceBased on principle of segregation of communal waste from BMWs,followed by containment treatment and disposal of differentfollowed by containment, treatment, and disposal of differentcategories of BMW.Classify BMWs into 10 categories and require specific containment,treatment and disposal methods for each waste categorytreatment, and disposal methods for each waste category.Treatment options include autoclaving, microwaving, incineration, andchemical treatment;

Hydroclaving approved by CPCB as an alternative treatment– Hydroclaving approved by CPCB as an alternative treatmenttechnology.

BMW disposal options include deep burial and secure and municipallandfilling for solid wastes and discharge into drains (after chemicallandfilling for solid wastes, and discharge into drains (after chemicaltreatment) for liquid wastes.


Main FeaturesMain FeaturesState Pollution Control Boards (SPCBs) in statesand Pollution Control Committees in territoriesand Pollution Control Committees in territoriesresponsible for permitting and enforcing therequirements of the Biomedical Waste Rules.q

Each occupier (operator) handling BMWs andac occup e (ope ato ) a d g s a dproviding services to 1,000 or more patients permonth required to obtain a permit from theprescribed authority.


Main FeaturesMain FeaturesBiomedical waste: Any waste that is generatedd i th di i t t t i i ti fduring the diagnosis, treatment, or immunization ofhuman beings or animals, or in research activitiespertaining to or in the production or testing ofp g p gbiologicals.

The rules apply to all persons who generateThe rules apply to all persons who generate,collect, receive, store, transport, treat, dispose, orhandle BMWs in any form.


It is the duty of the occupier (operator) of ahealth care facility that is hospital nursinghealth care facility—that is, hospital, nursinghome, clinic, dispensary, veterinaryinstitution, animal house, pathologicalinstitution, animal house, pathologicallaboratory, blood bank—to ensure thatBMWs are handled without any adverseeffect to human health and the environment,and according to the prescribed treatment

d di l i t i th Bi di land disposal requirements in the BiomedicalWaste Rules.


Main FeaturesMain FeaturesEach occupier (operator) required to maintainrecords on the generation, collection, reception,g , , p ,storage, transportation, treatment, and disposal ofBMWs. All records subject to inspection andverification by the prescribed authority at anyverification by the prescribed authority at anytime.Each occupier (operator) required to report anyEach occupier (operator) required to report anyaccident related to the management of BMWs.Each occupier required to submit an annualreport to the prescribed authority to provideinformation about categories and amounts ofwastes generated and treated and modes ofwastes generated and treated, and modes oftreatment.


Main FeaturesMain FeaturesLocal public entities required to provide

di l/i i ti it dcommon disposal/incineration sites, andoccupiers (operators) of such sites requiredto comply with Biomedical Waste Rulesto comply with Biomedical Waste Rules.

BMWs not to be mixed with other wasteBMWs not to be mixed with other waste.According to the Rules, BMWs to besegregated into labeled bags/containers.segregated into labeled bags/containers.


Main FeaturesMain Features

Transportation of BMWs to be conducted inTransportation of BMWs to be conducted inauthorized vehicles. No untreated waste tobe stored more than 48 hours unlessbe stored more than 48 hours, unlessspecial permission is obtained fromregulatory authorities.Technology and discharge standards forincineration, autoclaving, microwaving, liquidwaste discharges, and deep burialprescribed in the Biomedical Waste Rules.


RulesRules

Related to:– Duty of occupier

Segregation packaging transportation– Segregation, packaging, transportation, storage of waste

– Treatment and disposal of waste– Prescribed authority and authorization– Advisory committee– Annual report and maintenance of recordsAnnual report and maintenance of records– Accident reporting– Appeal


SchedulesSchedules– Categories of bio-medical waste– Color coding and type of container for

disposal of bio-medical wastes– Label for bio-medical waste containers/bags– Label for transport of bio-medical waste

t i /bcontainers/bags– Standards for treatment and disposal of bio-

medical wastesmedical wastes– Schedule for waste treatment facilities like

incinerator/ autoclave/ microwave systemincinerator/ autoclave/ microwave system


Forms

Form I - Application For AuthorisationB t t d t f CTF– By waste generator and operator of CTF

– To prescribed authority– Along with prescribed fee

Form II – Annual Report – By Waste generator/operator – To prescribed authorityTo prescribed authority – include information about the categories and quantities of

bio-medical wastes handled during preceding year.sent by 31 January every year– sent by 31 January every year

Form III - Accident Reporting– By authorized person of facility where accident occurred– To prescribed authority


DefinitionsDefinitions "Authorization“ means permission granted bythe prescribed authority for the generationthe prescribed authority for the generation,collection, exception, storage, transportation,treatment, disposal and/or any other form oftreatment, disposal and/or any other form ofhandling of bio-medical waste in accordancewith these rules and any guidelines issued bythe Central Government.


"Authorized person" means an occupier oroperator authorized by the prescribed authorityoperator authorized by the prescribed authorityto generate, collect, receive, store, transport,treat, dispose and/or handle bio-medical waste inaccordance with these rules and any guidelinesissued by the Central Government;


Bio-medical waste: any waste, which is

generated during the diagnosis, treatment or

immunisation of human beings or animals or ing

research activities pertaining thereto or in the

d ti t ti f bi l i l dproduction or testing of biologicals, and

including categories mentioned in Schedule ;


Biologicals: any preparation made from

organisms or micro-organisms or product of

metabolism and biochemical reactionsmetabolism and biochemical reactions

intended for use in the diagnosis, immunisation

or the treatment of human beings or animals or

in research activities pertaining thereto;p g ;


"Bio-medical waste treatment, facility" means

any facility wherein treatment. disposal of bio-

medical waste or processes incidental to suchp

treatment or disposal is carried out {and includes

t t t f iliti }common treatment facilities}


"Operator of a bio-medical waste facility"means a person who owns or controls ormeans a person who owns or controls oroperates a facility for the collection,reception,storage, transport, treatment,disposal or any other form of handling of bio-medical waste;


Duty of Occupier (Rule- 4)

It shall be the duty of every occupier of aninstitution generating bio-medical waste whichincludes a hospital, nursing home, clinic,dispensary, veterinary institution, animal house,pathological laboratory blood bank by whateverpathological laboratory, blood bank by whatevername called to take all steps to ensure that suchwaste is handled without any adverse effect towaste is handled without any adverse effect tohuman health and the environment.


Treatment and Disposal (Rule 5)Treatment and Disposal (Rule-5)

Bio-medical waste shall be treated anddisposed of in accordance with Schedule I,and in compliance with the standardsprescribed in Schedule-V.


Every occupier, where required, shall set up inaccordance with the time-schedule in ScheduleVI, requisite bio-medical waste treatmentfacilities like incinerator, autoclave, microwavesystem for the treatment of waste or ensuresystem for the treatment of waste, or, ensurerequisite treatment of waste at a common wastetreatment facility or any other waste treatmenttreatment facility or any other waste treatmentfacility.


Categories of Waste-Schedule-I

S No

Waste type Treatment Container color

Container type

01 Human anatomical waste Deep burial YellowYellow HDPE Bags0 pIncineration /

g

03 Microbiology & Bio-Technology waste

AutoclaveMicrowaveI i ti

Yellow/ Yellow/ RedRed

Plastic bags/Disinfected

t iIncineration containers04 Waste sharp Disinfection/

Autoclaving/ Micro waving/

BlueBlue Plastic bags/Puncture proof containersMicro waving/

Shreddingcontainers

05 Discarded medicines & cytotoxic drugs

Incineration/Secured

Black Plastic bagscytotoxic drugs landfill

06 Solid waste-soiled/contaminated-Contaminated items with

I, M, A REDRED Plastic bags/Disinfected containersContaminated items with

blood/ body fluids (cotton, dressings, soiled casts

containers

Categories …..

0707 Solid wasteSolid waste--disposabledisposable

D, A, M, D, A, M, ShreddingShredding

Red/ Blue Plastic bagsPlastic bags

0808 Liquid wasteLiquid waste Disinfection &Disinfection &Discharge in Discharge in drainsdrains

- --

0909 Incinerator ashIncinerator ash LandfillLandfill Black Plastic bagsPlastic bags

1010 Chemical wasteChemical waste Discharge in Discharge in drains/drains/Land fill for Land fill for

Black Plastic bagsPlastic bags

solidssolids

category 2 deals in animal wastecategory 2 deals in animal wastecategory 2 deals in animal wastecategory 2 deals in animal waste


Color coding & Type of Container-Schedule -IISchedule II

Color Container Category Treatment

Yellow Plastic bag 1, 2, 3, 6 Incineration / Deep burial

Red Disinfected 3 6 7 Autoclaving/Red Disinfected Container/Plastic bag

3, 6, 7 Autoclaving/Micro waving

Bl / Whit Pl ti b / 4 7 A t l i /Blue / Whitetranslucent

Plastic bag/Puncture proof

4, 7 Autoclaving/Micro waving/Chemical

Black Plastic bag 5, 9, 10 Secured LandfillLandfill


Labels for Bio-medical Waste ContainersContainers Schedule-III

Bio-hazard Symbol Cytotoxic hazard Symbol


Label for Transport of Bio-medical Waste Containersmedical Waste Containers

Schedule-IVWaste category… 5

27/09/02Generated on….

26/09/02SSender… Receiver…

In case of emergency-contact…..

Label to be non-washable & prominentSIHFW: an ISO 9001: 2008 certified institution 36

Standards for Treatment & DisposalDisposal

Schedule- VIncineratorsIncinerators

A. Operating Standards--Combustion efficiency- min. 99%Temp of pri Chamber 800+/ 50 C-Temp. of pri. Chamber-800+/- 50 C

-Sec. chamber gas residence time-1 sec. at 1050+/-50 C with 3% Oxygen in stack gas

B Emission StandardsB. Emission Standards-Particulate matter--- 150 mg/Nm3 at 12% CO2Nitrogen oxides --- 450HCl 50HCl --- 50Minimum Stack height --- 30 meters above

groundVolatile compounds in ash < 0 01%Volatile compounds in ash --- < 0.01%


Standards for Liquid Wastes-Standards for Liquid Wastes

Ph 6.5-9.0Suspended solid 100 mg/lOil & grease 10mg/lBOD 30mg/lCOD 250 mg/lBio-assay test 90% survival

of fish after 96 hrs in 100% ffl t100% effluent


Standards for AutoclavingStandards for Autoclaving

For gravity flow autoclave-121 C, pressure 15 pounds/ psi- 60 mts.p p p135 C , 31 pounds/psi -45 mts.149 C, 52 pounds/psi- 30 mts., p p

For vacuum autoclave-121 15 45 mts121,15,45 mts.135,31,30 mts


For Deep BurialFor Deep Burial

Trench-2 meters deep, half filled, covered with lime, fill rest with soilNo access of animals a layer of 10 cm. of soil each timeNo water source close to trenchLocation to be specified by authority


Schedule for Waste Treatment F ilitiFacilities

Schedule-VIA. Hospitals & NH in towns 31/12/1999

with pop. 30 & >with pop. 30 & B. With Pop. < 30 lacs-

500 beds 31/12/1999500 beds 31/12/1999200-500 beds 31/12/200050 200 beds 31/12/200150-200 beds 31/12/2001< 50 beds 31/12/2002

C All other not included in A & B 31/12/2002C. All other not included in A & B 31/12/2002


Waste GeneratorWaste GeneratorIn compliance with Bio-medical waste (Management & Handling) Rules1998 the health care facilities are& Handling) Rules1998, the health care facilities are required to obtaining authorization / renewal of authorization certificate from state pollution control b dboard. Obtaining authorization from RPCB is necessary for all health care facilities with registered patient (OPD g p (& IPD) in excess of 1000 per calendar month. Responsible to segregate waste and put in the

l t d l b /birelated colour bags/bins.Waste bags to be stored at specified place.


Health Care Facility Waste Management Plan

Generation / Minimization: Significantgreduction of waste generated in healthcarefacilities by adopting the principles of 3 R’s,i.e., Reduction, Recycle and Reuse.Waste Segregation: at the point of

ti ll ti t ti itgeneration e.g. all patient activity areas,diagnostic service areas, operationtheatres labor rooms treatment rooms etctheatres, labor rooms, treatment rooms, etc.Responsibility of segregation lies with thegenerators of bio-medical waste, i.e.,g , ,doctors, nurses, technicians, etc.


C ll i O l hl i d l iCollection: Only non-chlorinated plasticcollection bags. Waste collected daily andtransported to the designated storage site /transported to the designated storage site /deep burial pits. Bags removed after 2/3 rdfilled with bio medical waste.ed t b o ed ca asteTransportation: Designated routes and timeof transfer of wastes to avoid the passage ofp gwaste through crowded and patient careareas. Wheeled containers, trolleys/carts totransport the plastic bags to the site ofstorage / deep burial.


Storage: A storage location for hospital wasteStorage: A storage location for hospital wastecollection is designated inside the establishment.End Treatment and Disposal: The CTFs areresponsible for waste collection and transportationfrom the hospitals site, followed by treatment anddestruction as necessary and finally disposal at thedestruction as necessary and finally disposal at thesite of CTF. There is a provision of payment for CTFhiring charges to CTF operators through RHSDP atth t f R 1000/ b d f j tthe rate of Rs. 1000/- per bed per year for project-supported facilities only. The payment for CTF hiringcharges is being made through RMRS; which isreimbursed on actual basis.Burial Pits / Storage: in absence of CTF, infectiouswaste along with the anatomical waste and otherwaste along with the anatomical waste and otherhazardous waste is disposed off into deep burial pits.


Common Bio-medical Waste Treatment Facility

A set up where biomedical waste, generated from a number of healthcare units, is imparted necessary treatment to reduce adverse effects that this waste may pose.


Owner of CTF seeks authorization from the prescribed authority (PCB) under the BMW Rules, before installing the equipment and treatment techniques. F I l ith fForm I along with fee.


NeedInstallation of individual treatment facilities by small healthcare units requires comparatively high capitalhealthcare units requires comparatively high capital investment.Separate manpower and infrastructure p pdevelopment required for proper operation and maintenance of treatment systems.Risk of proliferation of treatment equipment in aRisk of proliferation of treatment equipment in a city.Monitoring pressure on regulatory agencies.g p g y gBy running the treatment equipment at CBWTF to its full capacity, the cost of treatment of per kilogram gets significantly reducedkilogram gets significantly reduced.


CoverageCoverage

One CBWTF allowed to cater up to 10,000 beds at the approved rate by the Prescribed Authority. Not allowed to cater healthcare units it t d b d di f 150 ksituated beyond a radius of 150 km.

Where 10,000 beds not available within a di f 150 k th CBWTF bradius of 150 km, another CBWTF may be

allowed to cater the healthcare units situated outside the said 150 kmsituated outside the said 150 km.


LocationLocation

Place reasonably far away from residential and sensitive area.Near to its area of operation as possible in order to minimize the travel distance in

t ll ti th h i itwaste collection, thus enhancing its operational flexibility. D id d i lt ti ith th t tDecided in consultation with the state pollution control board (spcb)/pollution control Committee (PCC)control Committee (PCC).


Essential Treatment EquipmentsEssential Treatment Equipments

IncinerationAutoclaving/ Microwaving/ Hydroclavingg g y gShredderSharp pit/ Encapsulationp p pVehicle/Container Washing FacilityEffluent Treatment PlantEffluent Treatment Plant


Infrastructure Set upInfrastructure Set-up

Treatment Equipment RoomMain Waste Storage RoomTreated Waste Storage roomTreated Waste Storage roomAdministrative RoomGenerator SetSite SecurityParkingSign BoardSign BoardGreen BeltWashing Roomg


RecordsRecords

Records of Waste MovementsLogbook for the Equipmentg q pSite Records


Guidelines to CBWTFGuidelines to CBWTF

Not accept the non-segregated waste. Report such incident to be reported to the Prescribed Authority. Coloured bags handed over by the h lth it t b ll t d i i ilhealthcare units to be collected in similar coloured containers with cover.


Guidelines to CBWTFGuidelines to CBWTF

Each bag shall be labeled as per the Schedule III & IV of the Bio-medical Waste (Management & H dli ) R l H l i ki h h l h& Handling) Rules. Helps in tracking the health care units not segregating the wastes as per rulesrules.The coloured containers should be strong enough to withstand any possible damage that g y p gmay occur during loading, transportation or unloading of such containers. Containers to be labeled as per the Schedule III of the Ruleslabeled as per the Schedule III of the Rules.


Guidelines to CBWTFSharps shall be collected in puncture resistant container.

f fThe person responsible for collection of bio-medical wastes shall also carry a register with him to maintain the records such as name of the healthcare unit, the type and quantity of waste received, signature of the authorized person from the healthcare unit side, day and time of collection etc.and time of collection etc.Transported to the CBWTF in a fully covered vehicle with separate cabin for driver and staff.cost to be charged from the healthcare units shall be worked out in consultation with the State Pollution Control Board/Pollution Control Committee and the local Medical Association.


Pollution Control BoardPollution Control Board

Monitoring HCWM activities in health sectorIssuing authorization/ renewal to the health facilitiesG fGetting annual reports from health facilitiesL l tiLegal actionIssuing license to the CTF operator


Process of Waste HandlingProcess of Waste Handling

Waste generation

Treatment Collection off sitegeneration

Storage at source

Collection on site

Waste disposal


Issues

Appropriate environmental conditions forAppropriate environmental conditions for treatment & disposalClimate (rainfall, temp.)( , p )Social acceptance of treatment & disposal sitesPerception of types & degree of human risksAccess & quality of support systemccess & qua ty o suppo t systeCostPolitical willPolitical will


Pre-conditions for Waste Management

Adequate time available to manage waste correctly Sufficient trainingType of medical services provided or excludedLarger set-ups need special inputs


Elements of Proper ManagementElements of Proper Management

Waste stream analysisWaste management and contingency plansWaste segregationWaste minimization- 3 RsProper collection, transport and storageWorker training, awareness programsAlternative treatment technologiesOccupational safety & Healthp y


Major ComponentsMajor Components-

Waste ReductionSegregation at point of generationg g p gStorageCollection/TransportpTreatmentDisposalDisposal


Waste Management ApproachWaste Management-Approach

R 3

Reduce

D 3

Disinfect

Reuse

R l

Distort

DiRecycle Dispose


What is Required is…toHave top management commitment to waste.waste.Involve personnel for proper segregation.Conduct ongoing TrainingConduct ongoing Training.Ensure safe transport and storage within hospital.hospital.Equip for segregation, occupational safety, sharps management, disinfections y, p g ,where needed.Ensure ongoing monitoring and g g gimprovement.


Collection AlternativesCollection Alternatives

Municipal waste collection system

Collection system from Private /Public sector health care facility

Storage/Transport from smaller units to g ppoint of disposal


Storage ConsiderationsStorage Considerations

Non-InfectiousInfectious-

SharpsSoftsAvailability of storage containersUse of makeshift containersUse of makeshift containersRate of generationFrequency of collectionFrequency of collection


General Activities-flowAll Mi d WAll Mixed Waste

Primary SegregationPrimary SegregationStorage

CollectionInfectious Waste Non-infectious Waste Treatment

NOYes

Disposal

StorageSecondary Segregation C ll tiSecondary Segregation Collection

TreatmentDisposal

Sharps Softsp

Storage StorageCollection CollectionTreatment TreatmentTreatment TreatmentDisposal Disposal


Waste Management AlternativesPackaging/(Syringes and Needles)

Other SoftsGenerated Separation

Pre-use

Packaging Syringes/Needles

Use

Managementof Used Syringe/Needle

MixedMixed

Storage StorageCollection CollectionTransport TransportTransport TransportDisposal Disposal


Waste Segregation Plan……Mi d W tMixed Waste

Segregate(At point of generation/collection in color coded containers)

Infectious( 10% ) General ( 85%) in Black BagsBlack Bags

S ll

color coded containers)

Segregate all plastic-

DisinfectAutoclave

Burial/L d fill Disposal throughHazardous waste

AutoclaveShredding

Land fill At CHC

Disposal through

Municipal system( 5%)

Radioactive Cyto-toxic drugs ( Black bag)

As per BARC rulesAs per BARC rules

Burial at CHC/SDH/DH

Incineration at DH level


Continue….

Infectious waste

Sharps InfectiousNeedle, Needle, Blades,Blades,ScissorsScissorsStore inBlue/White

Human tissue, organs, body parts

Items contaminatedWith body fluids, andMi bi l lt

Liquid wasteBlue/White

Translucent Translucent containerscontainers

A t l

Store in Yellow bags

Microbial cultures

Disinfect with 1%hypochlorite

Sanitary

AutoclaveDistort/cut

Deepburial

Autoclave/Microwave

hypochlorite

Linen in RedRedBB

Dressings,Casts,Cotton iny

landfill or

Special pits

AtCHC/SDH

IncineratorAt DH & AshThrough Municipal

BagsBagsLaunder & reuse

Cotton in Red bags

Autoclave

D MunicipalMunicipalsystem

Deep burial at CHC

Municipal system at SDH/ DH


Available TechnologiesAvailable TechnologiesSubstitute Destructive Technology

(waste & infectious nature both destroyed)( y )Incinerator

Substitute Non-Destructive Technology( l i f ti i d t d ith t h i(only infection is destroyed without change in composition)

AutoclavingAutoclavingChemical disinfectionMicrowave heatingHydroclavingPlasma Torch technologyAdvanced wet oxidationAdvanced wet oxidationDetoxification technology


Factors in Selection of TechnologyMinimum1. Environmental factors

Maximum1. Disinfection

2. Liquid discharges

3. Occupational hazard & volume d ti

efficiency

2. Quantum of weightreduction

4. Exposed handling3. Automation & control

4. Potential for recovery 5. Power consumption

6. Operational & maintenance cost

of energy or recyclable product in unrecognizable formcost

7. Air emissions-heavy metals, acid gas, odor

8. Recognizability of final productSIHFW: an ISO 9001: 2008 certified institution 72

Realistic AlternativesRealistic Alternatives

Low-Heat Thermal Technologies– Autoclaves or Retorts– Advanced Autoclaves– Microwave Units– Dry Heat Systems

ChemicalChemical– Non-Chlorine Technologies


Types of Treatment SystemsTypes of Treatment Systems

St ili ti Bi l i l I i tiSterilization Biological Incineration

Th lUncontrolled-

Thermal

Electro-magnetic

-Open pit

-Burn containerElectro-magnetic

RadiationControlled-

Chemical -Small incinerator

-Large incinerator


Alternative Medical Waste Treatment Technologies

AutoclavesMicrowavesPlasma ArcsPyrolysisy yChemical Disinfection


Factors to Consider in Selecting Alternative Technologies

Environmental Emissions and Residues– air emissions– wastewater discharges– solid residue– ambient (workspace) air– others

R d i f W V lReduction of Waste VolumeOccupational Safety & Health


Factors to Consider in Selecting Alternative Technologies

CapacityCapacityTypes of Waste TreatedSpace Requirements/ Site RequirementsSpace Requirements/ Site RequirementsProcess Monitoring and DocumentationE i t S f t d W k S f t D iEquipment Safety and Worker Safety During RepairsEase of Use/ Training Req irementsEase of Use/ Training RequirementsReliability/ Track RecordC tCost


Operating Standards1 Combustion efficiency (CE) shall be at leastStandards for 1.Combustion efficiency (CE) shall be at least 99.00%.2.The Combustion efficiency is computed as follows:

Incinerations

C.E. = %CO@/%CO2+%CO X 100

3.The Temperature of the primary chamber shall be 800 + 50 deg Coshall be 800 + 50 deg. Co.4.The secondary chamber gas residence time shall be at least 1(one) second at 1050+50 Co. with minimum 3% oxygen in the stack gas.with minimum 3% oxygen in the stack gas.

B. Emission StandardsParameters Concentration mg/Nm 3 at

(12% CO2 correction )Nitrogen oxides 450 HCI 50Minimum stack height -30 metersMinimum stack height -30 metersVolatile organic compounds in ash <0.01%.


And We Need toAnd We Need to…Concentrate on critical in-house issues of

waste management and minimization.

Avoid developing non-related technicalAvoid developing non-related technical

expertise.

Pay on waste generation basis rather than

on fixed capacity basison fixed capacity basis.

Ease regulatory requirements.


Role of Private sectorRole of Private sector

Improve efficiency & lower cost

Provide new ideas, technology & skills

Mobilize needed investment fundsMobilize needed investment funds


Issues That Still Haunt…

Questions of liability unresolved.

Quality of service not established.

Viability of operator economically

Health faculties tend to pass responsibilityHealth faculties tend to pass responsibility-

lead to in-hospital apathy.


Conclusions

Centralized facilities can help provide essential

service in waste management in urban settings.

I t ll ti f i t t h l iInstallation of appropriate technology mixes

and their capacities.p

Ensure Quality standards of operation both through

standardization of protocols as well as choice of

operators.p


FinallyFinally

High Tech Centralized Facilities to succeed haveHigh Tech Centralized Facilities to succeed have

to be viewed as a critical component, of the

overall waste management hierarchy which

extends from waste minimization on siteextends from waste minimization, on-site

segregation at point of generation to final

treatment and disposal offsite


Thank YoThank You

For more details log on towww.sihfwrajasthan.com

or contact : Director-SIHFW

on

[email protected]

Documents

Waste Management 12.6 - SIHFW) Rajasthan Management.pdf · linen & linen, Gloves, Catheters, Cannulas, Blood bags, Tape, Hot water Paper Glasses Flowers Milk Fluid bottles, Disposable